Can we afford to do cardiac operations in 1996? A risk-reward curve for cardiac surgery

Is it time to adopt beating-heart coronary artery bypass grafting? A review of literature

“…The major determinant of costs in conventional coronary artery surgery still remain the variable and fixed direct costs in terms of materials used for routine operations, postoperative care, and the management of postoperative complications [6,7]. Therefore, further savings could be obtained by using a surgical technique able to decrease the fixed direct cost while maintaining clinical quality of care [8].…”

Preoperative risk models for minimally invasive coronary bypass: A preliminary study

“…The risk of prolonged hospital stay after CABG was calculated by means of a regression equation based on the Parsonnet score. 2 The correlation coefficient between observed length of stay after CABG and the Parsonnet score is very high (r = 0.976). Length of hospital stay is also a good predictor of complication rate and of resource use.…”

“…The risk profile of patients being referred for surgical coronary revascularization has been steadily increasing in severity during this decade. 2 Recent studies suggest that elderly patients with greater comorbidities and advanced cardiovascular disease benefit more from cardiac surgery than from medical therapy, 22,23 yet they paradoxically have greater morbidity and mortality after cardiac surgery. 24,25 Despite the 30 years that have elapsed since the first CABG was performed by Favaloro in 1967, and myriad subsequent refinements in technique, major complications continue to be associated with CABG, resulting in prolonged hospitalizations and resource use.…”

Evolution of a Cardiovascular Information System

“…The caregiver must be an active participant in the data collection process in order to ensure that data elements collected and analyzed are relevant and correct. A recent publication addresses in depth the consequences and financial disincentives of a system where hospital net income decreases as patient risk increases (8). The implications for a cardiac surgery program are great, particularly in a capitated environment.…”